What are the symptoms of myasthenia gravis?

Myasthenia gravis is a disease that is very difficult to eliminate, and ordinary methods cannot eliminate this disease. The earlier myasthenia gravis is detected, the sooner it is, the less difficult it is, and the easier it is, so it is important to diagnose it early and correctly.

1. Changes in visual acuity: that is, double vision. Seeing together with two eyes, one thing becomes two; If you cover one eye, you see one.

Very young children do not describe diplopia, and often compensate for tilting their heads and torticollis so that they can see clearly because of their diplopia, and patients with severe myasthenia gravis can also present with strabismus and worsening the condition.

2. Facial muscle weakness: due to the weakness of the facial expression muscles of the whole face, patients with myasthenia gravis often cannot close their eyes when sleeping. Usually the expression is indifferent, and the smile is very unnatural, just like crying, also known as crying and laughing face. This countenance makes the person look very uncomfortable and the patient is in pain.

3. Drooping eyelids: also known as drooping eyelids. In our analysis of 3,100 myasthenia gravis, ptosis was the first symptom in 73% of patients with myasthenia gravis.

It can occur at any age, especially in children. Myasthenia gravis is mostly on one side in the early stage and on both sides in the late stage, and many patients have left and right alternate eyelids when one eyelid is stared up, and the other eyelid is drooping again, that is, there is a phenomenon of left and right alternate ptosis.

4. Weak chewing: The teeth are good, but the bite is weak, and even biting the steamed bun feels laborious. The first few bites are okay, but the more you bite, the more you can't move. It's even harder to eat pancakes and nibble on barbecue.

Hello! The first symptom of myasthenia gravis is often one or both extraocular muscle paralysis, such as ptosis, strabismus, and diplopia. When the facial and throat muscles are affected, there is an indifferent, wry smile; continuous chewing weakness, choking on water, difficulty swallowing;

Myasthenia gravis is not difficult to diagnose based on clinical features. Muscle fatigue tests, such as repeated eye openings, fist clenching, or upper limb raising, can make muscle weakness more pronounced and helpful in diagnosis. Avoid excessive fatigue; Contraindicate the use of all drugs that obstruct neuro-muscle transmission and various muscle relaxants; anticholinesterase drugs; adrenocorticosteroids and antimetabolic immunosuppressants; Thymectomy or radiation**; Plasma exchange**; Myasthenia gravis combined with crisis resuscitation principles.

The most common presenting symptoms of myasthenia gravis are ptosis and diplopia in both eyes. Patients may also have muscle weakness in the extraocular muscles, laryngeal muscles, or extremities alone at the beginning of the disease. This is followed by the gradual involvement of more skeletal muscles, from the face and limbs to the respiratory muscles, affecting normal life and even life-threatening.

Typical symptoms. The main symptoms are as follows:

Ptosis is caused by paralysis of one or both extraocular muscles, which may be accompanied by strabismus and diplopia, and in severe cases, eye movements are significantly limited, or even the eye is fixed, but the pupillary sphincter is not affected, that is, the pupillary accommodation function is normal;

Dysphagia and chewing: This is caused by the involvement of the facial and throat muscles, and at the same time, there will be an indifferent expression, a wry smile, continuous chewing weakness, choking on water, and more laborious swallowing of chewed food when eating;

Hoarseness: This is also caused by the involvement of the facial and throat muscles, which can be accompanied by nasal speech, dysphonia, and unclear pronunciation when speaking;

Difficulty raising head: when the sternocleidomastoid muscle and trapezius muscle are involved, it manifests as neck weakness, difficulty in raising the head, weakness in turning the head and shrugging the shoulders;

Weakness of the arms and legs: The muscles of the limbs are affected by proximal weakness, which is manifested as difficulty in raising the arms, combing the hair, and climbing stairs, but the tendon reflexes are usually unaffected and the sensation is normal;

Dyspnea: Respiratory muscle involvement often leads to adverse consequences, and medical attention should be sought as soon as possible if you experience difficulty breathing;

Morning and evening severity: this is a characteristic of the symptoms of the disease, i.e., daily fluctuations, muscle weakness that worsens after exertion in the afternoon or evening and lessens after morning or rest.

In some patients, when the respiratory muscles are affected, the generalized muscle contraction weakness or even muscle weakness occurs in the short term. Myasthenic crisis refers to the dangerous phenomenon that the patient suddenly develops severe dyspnea under the influence of a certain trigger, and the patient is unable to breathe normally. Once it occurs, patients need to be presented to the emergency department quickly, and myocardial involvement can occasionally occur, which can lead to sudden death.

Predisposing factors include respiratory tract infections, surgery (including thymectomy), stress, and systemic disease

Typical symptoms.

Drooping eyelids, blurred vision, diplopia, strabismus, bitter smile, etc.

Common symptoms: Patients with myasthenia gravis often feel soreness and discomfort in the eyes or limbs in the early stage of the disease, or blurred vision, fatigue is easily fatigued, and fatigue is aggravated by hot weather or menstruation. As the disease progresses, skeletal muscles become significantly fatigued and weak, which is characterized by muscle weakness that worsens after exertion in the afternoon or evening and decreases after getting up or resting, a phenomenon called "morning light and twilight heaviness".

Patients with myasthenia gravis can have systemic skeletal muscle involvement and may have the following symptoms1Drooping eyelids, blurred vision, diplopia, strabismus, and inflexible eye movement.

2.The expression is apathetic, the face is wry, the speech is large, and the arthritis is difficult, often accompanied by a nasal voice.

3.Weakness in chewing, choking on water, difficulty swallowing.

4.Weakness of the neck, difficulty raising the head, weakness of turning the neck and shrugging the shoulders.

5.Difficulty lifting arms, combing hair, going up stairs, squatting, and getting into the car.

Myasthenia gravis begins with muscle fatigue and can affect all muscles of the body, but it is often focused and predominantly localized.

Myasthenia gravis typically manifests as ptosis, generalized muscle weakness, relieved by rest, and mild in the morning and heavy at dusk. Other symptoms may include a weak neck, difficulty raising the head, inability to shrug shoulders, blurred vision, strabismus, etc. The critical situation is swallowing and swallowing, and it is difficult to breathe, if it appears, immediately emergency rescue and promotion of the bad wheel.

Myasthenia gravis is a relatively common neuromuscular junction problem, and its earliest manifestation may be extraocular muscle paralysis, which is the symptom of drooping of two eyelids, and then it may affect the limbs and muscles of the whole body, causing weakness of the limbs, even including throat muscle weakness, difficulty swallowing, hoarseness, choking on drinking water, and even involving respiratory muscles, it may cause dyspnea, which requires first aid**.

Myasthenia gravis is a relatively common autoimmune disease at the neuromuscular junction that can be treated primarily with surgical and pharmacological methods. Because about 80% of patients with myasthenia gravis will have thymoma or thymus hyperplasia, patients with myasthenia gravis generally undergo surgery** to remove thymoma, and the disease can be partially relieved.

Of course, drugs are an important means of myasthenia gravis, and large doses of hormone shocks can be used in the acute phase, but it should be noted that some patients will induce myasthenic crisis, and intravenous gamma globulin or plasma exchange can also be used, which can receive better resultsIn the remission period, immunosuppressants can be the mainstay, commonly used azathioprine, tacrolimus, cyclosporine A, etc., of course, some patients can also use symptomatic**, mainly the use of pyridostigmine bromide, which can relieve the symptoms of muscle weakness in patients.

Medications**: hormone impulses**, intravenous gamma globulin, or plasma exchange are available in the acute phase**;In the remission period, immunosuppressants are mainly used**, but symptomatic and cause-specific ** can also be used.

Myasthenia gravis is an autoimmune disease whose main symptoms include:

Subacute or chronic progressive muscle weakness: muscle fatigue and weakness, especially after a period of use.

Symmetrical muscle weakness: usually affects the mountain bridge muscles in both sides of the body at the same time.

Ophthalmoplegia: Fatigue of the eye muscles, resulting in the inability to focus both eyes at the same time.

Ptosis eyelids: Weakness of the eyelid muscles, causing the eyelids to droop violently.

Weakness of the laryngeal and neck muscles: Weakness of the muscles in the larynx and neck, leading to problems with speaking, swallowing, breathing, etc.

Fatigue: Severe muscle fatigue that interferes with daily activities.

If you suspect that you have myasthenia gravis, it is recommended to consult a doctor as soon as possible for diagnosis and**.

The symptoms of myasthenia gravis should be said to be diverse, because the skeletal muscles of the whole body can be affected, so the manifestations are also diverse, such as ptosis, which is the most common type of myasthenia gravis, which can manifest as single eye ptosis, or alternate drooping. The so-called alternate ptosis means that we now have a ptosis of the left eyelid, and it may be that after a while, the ptosis of the left eyelid will get better, and the right eyelid will droop again. Another can appear eye movement disorder, the patient first feels that the vision is not clear, and there is a phantom next to the sight, which we call diplopia.

There can also be chewing weakness, chewing something and chewing one or two bites may still be able to eat, but if you chew too much, you will not have the strength. You may also have difficulty swallowing, and choking when eating food and drinking water. Patients may also have symptoms of limb weakness, such as when the limbs can be combed, or when they can lift their limbs, or when they have difficulty climbing stairs.

Is there a problem with walking on a flat road? If the condition is aggravated, there can be weakness in the limbs, unable to walk at all, unable to lift the upper limbs at all, so you can only stay in bed. Of course, one of the most serious manifestations of this disease is respiratory muscle weakness, which will cause dyspnea at this time, but this kind of dyspnea is not the same as our common acute attack of bronchial asthma, the patient also assezes, but his main problem is caused by respiratory muscle weakness.

So at this time, it is a sign of critical illness, and we also call it myasthenic crisis. Myasthenia gravis is another major feature, all of which have a fluctuating nature, which is milder at rest and quiet, and aggravated after activity.

Myasthenia gravis is a chronic autoimmune disease with less obvious symptoms, mainly in the following aspects:

1.Ptosis eyelids: most common. It is manifested by drooping of one or both eyelids, diplopia, which may be relieved or disappeared after sleep rest, and worsened again after awakening.

2.Weakness of the limbs: Feeling weakness in the limbs, difficulty standing up, going upstairs, holding objects, or raising arms over the head.

3.Whispered voice: When you speak too much or too long, your voice becomes deeper and nasal. Difficulty chewing and swallowing.

4.Cough weakness: cough weakness and dyspnea occur when the intercostal muscles are affected. Failure to maintain ventilation is also referred to as a "crisis".

5.Symptoms of various types of muscle weakness are more likely to worsen in the afternoon or evening and lessen in the morning and after rest.

6.Weakened muscles but no sensory impairment.

The most prominent feature of muscle weakness is the extreme fatigue of the affected bone muscles, which recover to varying degrees after rest. The condition fluctuates, day by day. Many episodes are insidious, often starting with one group of muscles and progressively affecting other groups.

Cranial innervation muscles were the most common first, with drooping eyelids and diplopia accounting for more than 90% of the first symptoms, followed by bulbar muscles and limb girdle muscles.

Muscle weakness is not all muscles of the whole body are affected, often emphasized, extraocular muscles are most commonly involved, followed by the muscles innervated by cranial nerves, neck muscles, scapula muscles, and hip flexors, this disease presents pathological fatigue, weakness or even paralysis occurs after continuous contraction, and improves after rest, and is common in spontaneous relief or ** in the early 3 years of the course of the disease, or worsening, and the late stage of movement disorder is more serious, although it cannot be completely recovered after rest, and some muscles can be atrophied.

The above is a review of the question "What are the symptoms of myasthenia gravis?" "The advice on this issue, I hope it helps you, I wish you good health!

The onset is insidious, with muscles as the main symptom of weakness, muscles are strong in the morning, and the activity increases and gradually weakens, which is relieved after rest.

Myasthenia gravis can be seen at any age, and the age of onset of patients in China is more common in childhood, with more females at the age of 20 and 40, and most of the patients with onset after middle age are males, with thymoma more common. Once it is complicated, it will inevitably bring great physical and mental pain to the patient. For this reason, it is important to understand the symptoms of myasthenia gravis in order to diagnose and treat the condition in a timely manner.

Therefore, let's take a detailed look at the symptoms and manifestations of myasthenia gravis.

1) Ophthalmomy-type myasthenia gravis: the clinical characteristics are that the affected skeletal muscles are sickly fatigued, and the symptoms are mostly aggravated after exertion in the afternoon or evening, and reduced in the morning and after rest, showing regular fluctuating changes in morning and twilight. Muscle weakness is usually mild in the morning and severe in the evening, but it can also be changeable, and it can be in a state of incomplete paralysis in the later stage; Muscles are not evenly affected throughout the body, and extraocular muscles are often involved, which is an early symptom or may be confined to the eye muscles for a long time.

In mild cases, the eyes are weak, the eyelids droop, and the distribution is asymmetrical, and the frontalis muscle is compensated for contracting and lifting. Eye movement is limited, strabismus and diplopia occur, and in severe cases, the eye is immobile. The intraocular muscles are generally unaffected, and the pupillary reflexes are usually normal.

2) bulbar (or spherical) myasthenia gravis: facial muscles, tongue muscles, masticatory muscles and throat muscles are also easily affected; Incomplete closure of the eyes, flattening of frontal lines and nasolabial folds, weakness of the posterior constrictor muscles of the corners of the mouth than of levator lip muscles of the upper lip when laughing, and tooth exposure of the lip lift like a roar; weakness in chewing, difficulty swallowing, and inability to move the tongue; soft palatine muscles weak, nasal-sounding; A low or hoarse pitch after a moment of conversation.

3) Generalized myasthenia gravis: neck muscles, trunk and limb muscles can also suffer, showing difficulty in raising the head, and often holding the head with hands; chest tightness and shortness of breath, weakness in walking, inability to walk for long periods of time; It is difficult to wash face, comb hair, and dress; presence of tendon reflexes without sensory deficits; Respiratory muscles and diaphragm are affected, cough weakness, dyspnea occur, and severe cases can lead to death due to respiratory muscle paralysis secondary to aspiration pneumonia. Death can occur abruptly with even cardiac muscle involvement, while smooth muscle and bladder sphincter are generally unaffected; In severe cases, limb weakness occurs, with the upper extremity heavier than the lower extremity and the proximal more severe than the distal extremity.

Occasionally, muscle atrophy is seen.